Groundbreaking Double Partial Face and Eye Transplant Surgery at NYU Langone Health

2023-11-10 00:57:40
The NYU Langone Health surgical team during the double partial face and eye transplant operation, in New York on November 9, 2023. JOE CAROTTA / NYU LANGONE HEALTH

This is a new step in the history of facial transplantation. The first double partial transplant of the face and an entire eye took place on May 27 at New York Langone University Hospital (NYU), in the United States, the medical team announced Thursday, November 9, during a press conference.

The patient, Aaron James, 46, an Arkansas resident and former U.S. soldier, was electrocuted in June 2021 with more than 7,000 volts while working on a high-voltage line. The accident resulted in, among other things, the loss of his left eye, nose, mouth, chin and teeth, as well as part of his left arm. Supervised by Doctor Eduardo Rodriguez, plastic surgeon responsible for the facial transplant program at NYU, the project was imagined in August 2022. An ambitious plan which mobilized 140 people, all professions combined.

Forty-eight face transplants recorded worldwide

Since the first facial transplant carried out in France in 2005, only 48 face transplants have been identified across the world, according to a 2021 publication, and the eyes were only affected by partial transplants, mainly of the cornea. The few attempts at whole eye transplants – some dating back to the 19th century – have ended in failure, with one of the main challenges being reconnecting the optic nerve to restore vision.

Read also (2010): Créteil University Hospital announces the first total face transplant

So why try this procedure on Aaron James? In recent years, research has progressed significantly regarding immunosuppressive treatments, prescribed for life. to fight once morest transplant rejection. But these molecules are not harmless: beyond the risks of infections that they can induce, they remain likely to attack the kidneys or accelerate aging. « Given that Aaron needed a face transplant anyway requiring immunosuppressants, the risk/benefit ratio of an eye transplant was very low.”explains Doctor Rodriguez in a press release.

After just three months of waiting, a compatible donor is identified – size, skin color, biomarkers. To optimize the result, Dr. Rodriguez’s team used cutting-edge technologies. The Belgian company Materialize, specializing in 3D planning and manufacturing of tailor-made medical devices, stepped in to provide 3D models of the upcoming operation. She also designed custom 3D printed cutting guides “allowing us to take segments of bone from the donor and place them precisely on the recipient, like a puzzle”, explains Doctor Rodriguez. The titanium screws holding the bones together were supplied by the DePuy Synthes company, owned by the Johnson & Johnson group.

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